Organization Active NPI

McDonald Dermatology, PLLC

  • Dermatology Physician
  • Wichita Falls, TX
National Provider Identifier
1730845835
Registry record updated Apr 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
MCDONALD DERMATOLOGY, PLLC
Practice address
4206 Call Field Rd
Wichita Falls, TX 76308-2519
Phone
(940) 397-5200
Fax
(940) 397-5287
NPI assigned
Nov 12, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Bruce McDonald, DO
Title
Physician/Owner
Phone
(940) 781-1188

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

4206 Call Field Rd
Wichita Falls, TX 76308-2519

Mailing address

3105 S Gardenia CT
Broken Arrow, OK 74012-0899
Phone (940) 781-1188

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1636675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682553600000",
    "number": "1730845835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3105 S GARDENIA CT",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740120899",
            "telephone_number": "940-781-1188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4206 CALL FIELD RD",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763082519",
            "telephone_number": "940-397-5200",
            "fax_number": "940-397-5287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCDONALD DERMATOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-12",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A",
        "authorized_official_last_name": "MCDONALD",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "940-781-1188",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita Falls, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.